Suspected Vascular Trauma of the Extremities

We reviewed 72 patients with penetrating trauma to the extremities who underwent arteriography for proximity injury only. None of the patients had clinical evidence of vascular trauma. There were 62 males and ten females, with a mean age of 29.9 years. Gunshot wounds were the most common cause of injury (91.7%) and the thigh was the most common site of injury (47.2%). A normal arteriogram was found in 55 of 72 patients (76.4%). The remaining 17 patients (23.6%) had arteriographic abnormalities that did not warrant surgery. Only one patient was explored (1.4%) for spasm of the popliteal artery. No vascular injury was found at surgery. This study suggests that routine arteriography in proximity injury only may be unnecessary and that these patients could safely be admitted to the hospital for a 24-hour period of observation.